Association of hopelessness and sexual risk behavior among young African American men in San Francisco

Background: African American youth bear a disproportionate burden of sexually transmitted infections (STI) and HIV infections and face unique social environmental risks for STI/HIV infection such as high rates of incarceration and violence. It is posited that environmental stressors may lead to higher rates of hopelessness, which in turn leads to increases in risk taking behavior. We hypothesized that as hopelessness increases, sexual risk behavior will increase—specifically inconsistent condom use and number of casual sex partners.

Methods: Street-based recruitment was conducted in a low income neighborhood of San Francisco; 108 African American men 15 - 24 years old responded to a brief self-conducted survey in 2010. The survey included socio-demographic and sexual behavior questions and Beck's Hopelessness Scale. The associations between hopelessness and sexual risk behaviors were evaluated with multivariate logistic regression.

Results: The median hopelessness score was 2 (0 least hopelessness - 5 most hopelessness). About half of the men consistently used condoms with a casual partner. Men reported less consistent condom use with main partners. Of sexually active participants (n=96), 37.5% had two or more casual partners in the last three months. Increased hopelessness was associated with decreased consistent condom use with a casual sexual partner, adjusting for employment, socioeconomic status and education. (OR: 0.43, 95% CI: 0.25, 0.75).

Conclusions: These findings support the notion that hopelessness may negatively impact sexual risk-taking behavior in young males. Further longitudinal research is needed to explore causality and elucidate the relationship between social environmental factors, hopelessness, and behaviors among youth.